EPOCH方案治疗复发耐药B细胞非霍奇金淋巴瘤的临床研究  

Clinical study of EPOCH regimen for relapse patients or with resistance in the treatment of advanced B-Cell Non-Hodgkin lymphoma

作　　者：鲁明骞[1] 黄慧强[2] 许新华[1] 文彩红[1] 王杰[1] 

机构地区：[1]三峡大学第一临床医学院宜昌市中心医院肿瘤科,443003 [2]中山大学肿瘤防治中心

出　　处：《肿瘤研究与临床》2006年第3期161-162,共2页Cancer Research and Clinic

摘　　要：目的观察EPOCH方案治疗复发耐药B细胞非霍奇金淋巴瘤的临床疗效和毒副作用。方法选择经病理检查确诊的复发B细胞非霍奇金淋巴瘤患者30例,采用EPOCH方案化疗:每天VP1650mg/m2,ADM/THP10mg/m2,VCR0.4mg/m2,溶于500ml生理盐水后加入化疗泵持续静脉灌注96h,第1～4天;CTX750mg/m2,静脉滴注,第6天;每天泼尼松(PDN)60mg/m2,口服,第1～5天,21d为1周期,共行4～6周期,中位周期数为5。结果30例患者CR9例(30%),PR10例(33.3%),总有效率63.3%(19/30)。主要毒副反应为白细胞和血小板下降,其Ⅲ～Ⅳ度发生率分别为36.7%(11/30)和13.3%(4/30),其他不良反应少见。结论EPOCH方案是治疗复发或耐药B细胞非霍奇金淋巴瘤的有效解救化疗方案,持续静滴可能减少了肿瘤细胞的耐受性和耐药性,有效率较高,患者耐受性好,而且毒副反应小,值得临床进一步研究。Objective To observe the efficacy and toxicity of EPOCH regimen for patient with relapse or resistant advanced B-cell non-Hodgkin＇s Lymphoma. Methods 30 patients were treated by EPOCH regimen： Etoposide 50 mg/m^2, Doxoruhicin/Pirarubicin 10 mg/m^2, Vincristine 0.4 mg/m^2, infused over 96 hours on day 1 to 4, Cyclophosphamide 750 mg/m^2, iv on day 6, oral Predisone 60 mg/m^2 on day 1 to 5. All patients received 4 to 6 cycles of chemotherapy, median cycle was 5. Results All the 30 patients were treated by EPOCH regimen. The response rate for the whole group was 63.3 % （19/30）, including 9 complete responses （CR） （30 %） and 10 partial responses （PR） （33.3%）. Main toxicity was myelosuppression. The incidence of grade Ⅲ-Ⅳ neutropenia and thromhocytopenia respectively was 36.7 %（11/30） and 13.3 %（4/30）. Other toxicities were mild. Conclusion EPOCH regimen is effective for patients with relapsed or resistant advanced B-cell non-Hodgkin＇s Lymphoma. The response rate is high. Continuous infusion schedules of several chemotherapeutic agents may partially reverse chemo-resistance and reduce toxicity . EPOCH regimen is warranted with clinical study.

关 键 词：EPOCH方案 B细胞非霍奇金淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]